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NPI Code Detail

MEDICARE: AASTHA AMDC, LLC

MEDICARE: AASTHA AMDC, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QA0600XAdult Day Care Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
115-022OTHERMDMARYLAND STATE LICENSURE

General Provider Information

NPI Number : 1073165619
Entity Type Code : Organization
Provider Name (Legal Business Name) : AASTHA AMDC, LLC
Provider Business Mailing Address
First Line : 12210 PLUM ORCHARD DR STE 214
Second Line :
City : SILVER SPRING
State : MD
Zip : 20904-7913
Country : US
Telephone Number : 240-813-3446
Fax Number : 240-474-0069
Provider Business Practice Location Address
First Line : 12210 PLUM ORCHARD DR STE 214
Second Line :
City : SILVER SPRING
State : MD
Zip : 20904-7913
Country : US
Telephone Number : 240-813-3446
Fax Number : 240-474-0069
Authorized Official
Title or Position : CEO
Name : DR. SREE N SREENATH
Credential : PH.D., MNO
Telephone Number : 440-318-9660
Provider Enumeration Date : 07/14/2019
Last Update Date : 01/29/2020

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Directions to “AASTHA AMDC, LLC ” Practice Location

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